Times Of Swaziland: PHALALA FUND HAUNTED  BY E40 MILLION DEBTS

PHALALA FUND HAUNTED  BY E40 MILLION DEBTS
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BY MUSA SIMELANE on 26/03/2014 02:23:00


MBABANE – The Phalala Fund is still being haunted by debts to the tune of
nearly E40 million, the Ministry of Health has disclosed.
The debts, mainly unpaid remunerations to health service providers in and
outside the kingdom, were accrued from the year 2008 to 2012. The Fund is part
of the country’s national referral system for citizens needing specialised
treatment.
According to the Ministry of Health’s Senate Portfolio Committee Report which
was tabled in Parliament on Monday, the Fund has been faced with financial
challenges for years.
In fact, patient referrals to South Africa (SA) were ceased in October 2013
unless a case was considered a serious emergency.
Many health service providers in SA had taken a decision by that time to stop
giving service to Swazi patients brought through the fund.
Their main gripe was the late payments.
The report clarified that this was prior to the engagement of a company called
Health Share. Health Share is an intermediary that was hired to be responsible
for patient case management and logistical operations, including selection of
doctors, hospitals and lodging, where patients would receive treatment. In
addition, the company audited and reviewed all transactions with service
providers to prevent overcharging, over servicing and double payments.
“Health Share assisted in paying some of the arrears in addition to ensuring
current balances were paid. But, payments were slowed and eventually halted in
the fourth quarter of 2013. Rectifying this issue and resuming patient referrals
must be government’s highest priority,” stated the report.
It went on that the centralised payment process contributed significantly to
delays in payment of service providers. The processes required that invoices
must go through multiple reviews within the Ministry of Health and then to the
Treasury Department, which is a semi-autonomous function of the Ministry of
Finance.
There was a recommendation though, that decentralising the current process and
providing the ministry with the authority to autonomously review, approve, and
pay medical bills can assist in preventing any further delays.
Strategies to bring efficiency were outlined as follows:
Similar to Health Share’s payment system with the government of Botswana, the
Ministry of Health should establish a satellite office at its embassy in South
Africa. The office will communicate with Health Share and review medical
invoices and process payments.
On a monthly basis the office will be wired a lump sum from the Treasury
Department for expected expenditures. This will eliminate the transport of
invoices back into Swaziland for review by Phalala Fund office and other
government departments.  Health service providers will get to be paid on time.
The Ministry of Health can establish an individual responsibility centre for the
Phalala Fund. Currently, the Fund shares its budget with the Mbabane Government
Hospital and other responsibility centres, which results in unrealiable and
depleted funds.
Phalala Fund can open a commercial bank account or imprest account where it
would have immediate access and have the ability to draw down funds.